脑卒中患者赋能护理现状及影响因素研究

目的了解脑卒中患者赋能护理现状,并分析其影响因素,为临床护理人员采取有效赋能护理措施提供依据。方法采用自行设计的一般资料问卷、脑卒中患者赋能调查问卷及一般自我效能感量表,对120例脑卒中患者进行调查。结果脑卒中患者赋能护理总均分3.02±0.81;影响因素包括一般自我效能、婚姻状况、年龄、陪护类型(P0.05,P0.01)。结论脑卒中患者对赋能护理的感知程度不高,护理人员应对不同自我效能、婚姻状况、年龄和陪护类型的患者,给予针对性的赋能措施,鼓励其参与疾病治疗和护理,促进其康复。     

首发脑卒中患者康复锻炼行为执行意向及影响因素分析

目的 了解首发脑卒中患者康复锻炼行为执行意向水平及其影响因素,为脑卒中患者康复锻炼行为的干预提供参考.方法 采用一般资料调查表、中文版脑卒中康复自我效能量表、社会支持量表、自行设计的脑卒中患者康复锻炼行为执行意向问卷对177例首发脑卒中患者进行调查.结果 首发脑卒中患者康复锻炼行为执行意向得分62.69±17.27.回归分析结果显示,个人月收入、自我效能、社会支持是首发脑卒中患者康复锻炼行为执行意向的影响因素(P＜0.05,P＜0.01),解释总变异的51.90％.结论 首发脑卒中患者康复锻炼行为执行意向处于中等水平,护理人员应重视首发脑卒中患者康复锻炼行为执行意向的评估及干预,促进康复锻炼行为的形成,更好地促进其康复.     

慢性乙型病毒性肝炎患者焦虑状况及影响因素

目的 了解慢性乙型病毒性肝炎(下称慢性乙肝)患者的焦虑状况及其影响因素,为实施针对性的心理护理提供依据.方法 应用自行设计的问卷及状态一特质焦虑量表对67例慢性乙肝患者进行调查.结果 慢性乙肝患者的状态焦虑和特质焦虑得分显著高于北京及长春地区的正常人(均P＜0.05);影响慢性乙肝患者状态焦虑的主要因素有年龄、职业、经济状况、文化程度(P＜0.05,P＜0.01),影响特质焦虑的主要因素有经济状况、婚姻状况和文化程度(P＜0.05,P＜0.01).结论 慢性乙肝患者焦虑水平较高,年龄、职业、经济状况、文化程度及婚姻状况是主要影响因素;护理人员应重视其人口学资料的收集及心理状况的评估,以实施针对性心理护理.     

社区中老年脑卒中患者药物素养现状及影响因素分析

目的 探究社区中老年脑卒中患者药物素养现况及影响因素,为制定干预措施提供依据。方法 采用一般资料调查表、药物素养调查问卷、合理用药自我效能量表、中文版服药信念特异性问卷及中文简化版双向社会支持量表对278例社区中老年脑卒中患者进行调查。结果 社区中老年脑卒中患者药物素养得分为4.79±1.75;多元线性回归分析显示,家庭人均月收入、服药必要性、合理用药自我效能及提供工具支持是患者药物素养的主要影响因素（均P＜0.05）。结论 社区中老年脑卒中患者药物素养为中等水平,社区医护人员应结合患者药物素养的影响因素制定个性化干预措施,提升患者的药物素养水平。     

冠心病患者生活质量与自我效能的相关性研究

目的 探讨冠心病患者生活质量与其自我效能的关系,为提高冠心病患者的生活质量提供新思路.方法 采用一般资料问卷、简明健康状况调查问卷(中文版)和一般自我效能感量表,对93例冠心病患者进行问卷调查.结果 冠心病患者生活质量总分为99.25±17.93,自我效能评分为25.27±6.35;生活质量总分及其各维度与自我效能呈正相关(P＜0.05,P＜0.01).结论 冠心病患者生活质量处于中等水平,自我效能感较低;冠心病患者的自我效能与生活质量密切相关.护理人员应加强对冠心病患者自我效能感的培养,以改善和提高其生活质量.     

脑卒中高危人群体力活动现状及影响因素研究

目的了解脑卒中高危人群体力活动水平及影响因素,为临床制订针对性干预措施提供参考。方法采用一般资料问卷、锻炼自我效能量表、患者健康问卷抑郁量表和国际体力活动问卷对上海市4个社区脑卒中高危人群272人进行调查。结果脑卒中高危人群中,1周总体力活动量为1872(569,2859)MET-min/周;体力活动强度中等以上占比69.5%;体力活动类型以家务及休闲为主,分别占比34.3%和41.6%。年龄、性别、家庭月收入及锻炼自我效能是脑卒中高危人群体力活动的主要影响因素(P<0.05,P<0.01)。结论脑卒中高危人群体力活动水平较低,尤其是40~59岁、男性、家庭月收入高、锻炼自我效能低者,应给予针对性护理指导,提高此类人群的体力活动水平。     

护士角色宽度自我效能现状及影响因素分析

目的 调查护士角色宽度自我效能现状及影响因素,为实施针对性干预,提升护理队伍角色宽度自我效能水平提供参考.方法 采用主动性人格量表、家庭关怀度指数问卷、变革型领导量表、差错管理氛围测量量表和角色宽度自我效能测量量表对山东省8所医院484名护士进行调查.结果 护士角色宽度自我效能得分为19.42±5.62,学历、主动性人格、家庭关怀指数、变革型领导及差错管理氛围是角色宽度自我效能水平的影响因素(P＜0.05,P＜0.01),能解释总变异的39.5％.结论 护士角色宽度自我效能处于中等水平,其影响因素较多.护理管理者可通过采取实施变革型领导、建立良好的差错管理氛围等有效措施帮助护士提高角色宽度自我效能,稳定和发展护理队伍.     

脑卒中患者口腔健康素养现状及其影响因素分析

目的 调查脑卒中患者口腔健康素养现状并分析其影响因素,为制订个体化干预方案提供参考.方法 采用人口学资料及相关影响因素调查表、脑卒中患者口腔健康素养量表、口腔生活质量影响程度量表、汉密尔顿抑郁量表对199例脑卒中患者进行调查.结果 脑卒中患者口腔健康素养总分为(82.24±5.90)分;脑卒中患者口腔健康素养与口腔生活质量影响程度及抑郁呈负相关(均P＜0.01).文化程度、居住地、领悟社会支持、营养状态、婚姻状态、医疗支付方式、经济来源、吞咽功能、患慢性病种数、自觉经济压力、神经系统功能、自我感受负担、主要陪护者是脑卒中患者口腔健康素养的影响因素(P＜0.05,P＜0.01).结论 脑卒中患者口腔健康素养有待提高,其影响因素较多.医护人员应采取针对性措施提高患者的口腔健康素养.     

实习护生自我效能感与护患沟通能力相关性分析

目的 了解实习护生护患沟通能力、自我效能感现状,探讨两者之间的相关性,分析护生护患沟通能力影响因素,为护理教学中帮助护生提高临床护患沟通能力提供借鉴.方法 采用一般资料问卷、一般自我效能感量表,对在三级甲等医院临床实习的2005级本科及2006级专科护生共60名进行调查.同时,采用护理专业护生护患沟通能力评价问卷对60名临床带教教师进行调查,了解以上60名护生的护患沟通能力.结果 护生自我效能感平均得分27.30±3.50,条目均分为2.73±0.35;护生护患沟通能力总分151.60±18.91,为理论最高值210分的72.19%,以中等居多(55.00%).一般资料中影响护患沟通能力总分的因素包括性格类型、父母职业、教师评价及临床操作技能成绩(P＜0.05,P＜0.01).护生护患沟通能力总分及各因子和自我效能感呈显著正相关(均P＜0.01).结论 护生自我效能感及护患沟通能力中等偏上.     

临床护理人员生活质量调查分析

目的了解临床护理人员的生活质量并探讨其影响因素.方法采用SF-36生活质量调查问卷对201名护理人员进行测评分析.结果护理人员生活质量自评分显著低于普通人群(P＜0.05,P＜0.01),护理人员的年龄、工龄、职称主要对其躯体健康造成影响,而学历、收入、环境、社会支持及慢性病不仅影响护理人员的躯体健康,更影响其精神健康,学历对护理人员的社会功能产生影响.结论护理人员的生活质量和健康状况值得关注.护理管理部门、护理教育机构和护理人员自身都要采取积极措施提高护理人员的生活质量.     

Self-efficacy and self-management behaviors in patients with chronic kidney disease

Although past research has examined self-management among patients with end-stage renal disease (ESRD), little is known about self-management in patients with chronic kidney disease (CKD). In this cross-sectional survey (no intervention), 174 patients with CKD (serum creatinine > or =1.7 mg/dL) completed self-reported measures of self-efficacy, physical and mental functioning, and self-management. The purpose of the study was to explore the association between patients' perceived self-efficacy and their self-management behaviors. Five types of self-management behaviors were measured: communication with caregivers, partnership in care, self-care, self-advocacy, and medication adherence. Controlling for other relevant variables including age, education, diabetic status, hypertension, serum creatinine, physical functioning, and mental health functioning, higher perceived self-efficacy scores were associated with increased communication, partnership, self-care, and medication-adherence behaviors. In this study, patients' perceived self-efficacy was a more consistent correlate of self-management behavior than were demographic or health characteristics. Because self-management has been associated with positive patient outcomes, fostering self-management by supporting patient self-efficacy may have long-term benefits.     

出院肺结核患者护理服务项目设置需求研究

目的 探讨出院肺结核患者护理服务项目设置需求,为建立肺结核患者出院后续护理服务管理体系提供依据.方法 采用自制调查问卷对出院的688例肺结核患者进行调查,内容包括肺结核患者出院后的后续管理服务、与医疗相适应的护理服务、专科健康教育、预防保健共4个维度,37个条目.结果 64.1％出院肺结核患者对护理服务项目完全需求,23.3％部分需求,12.6％不需求,对出院后4个维度的服务项目需求率为61.3％～95.6％,51.3％患者能承受基本费用在800～1 000元/月,出院肺结核患者护理服务项目需求受患者年龄、家庭经济因素、医疗费用支付方式、患者的自理能力以及患者文化程度的影响（P＜0.05,P＜0.01）.结论 大多数肺结核患者出院后需要各种护理服务项目,应当健全出院肺结核患者各种护理服务项目体系,满足不同层次的出院肺结核患者的护理服务需求.     

老年人家庭照顾者对居家照护指导服务的支付意愿及其影响因素研究

目的 了解老年人家庭照顾者支付居家照护指导服务的意愿以及愿意支付的费用,并探讨其影响因素.方法 用条件价值评估法调查上海市277名老年人家庭照顾者,调查问卷主要包括4个部分：对居家照护指导服务及调查情况的描述,照顾者对居家照护指导服务的支付意愿,照顾者社会经济学特征,对问卷的理解程度.结果 绝大多数照顾者对居家照护指导服务持肯定态度,愿意支付一定费用的照顾者有164名（59.2％）.其中111名（67.7％）愿意支付居家照护指导服务的费用低于10元/次.影响照顾者对居家照护指导服务支付意愿的因素有：分担照顾责任的人数、家庭人口数、照顾年限（P＜0.05,P＜0.01）.结论 照顾者对老年人居家照护指导持肯定态度,但支付意愿偏低,且支付意愿受到多种因素影响.     

综合医院临床护士健康促进生活方式调查

目的了解综合医院临床护士的健康促进生活方式及与人口学特性的关系。方法采用随机整群两级抽样法抽取成都市3所三甲综合医院的临床护士585名，运用健康促进生活方式量表-Ⅱ和一般资料调查表进行问卷调查。结果研究对象的健康促进生活方式平均得分为71．58±20．12，其中人际关系得分最高，而身体活动、健康责任得分较低。护士年龄、工作年限、婚姻状况、自觉身体状况、每月自由支配的资金、是否参加过健康促进课程是影响其健康促进生活方式的因素（P〈0．05。P〈0．01）。结论综合医院临床护士的健康促进生活方式欠佳，护理管理者需注重护士的身体活动和健康责任，加强举办健康促进相关课程，以增进护士的健康生活理念和身心健康。     

社区老年留置胃管患者口腔健康调查及影响因素研究

目的了解社区老年留置胃管患者口腔健康状况并分析其影响因素。方法采用一般资料调查问卷、日常生活活动能力量表、改良版Beck口腔评分表和流行病研究中心抑郁调查量表,对127例社区老年留置胃管患者及其主要照护者进行调查,并对患者口腔pH值进行测量。结果社区老年留置胃管患者Beck口腔得分为(10.02±2.39)分,96.85%患者存在不同程度的口腔功能受损,71.65%患者口腔pH值呈酸性。多重线性回归分析结果显示,患者胃管留置时间、清洁口腔频率、口腔pH值,以及照护者与患者关系、刷牙频率、抑郁程度为老年留置胃管患者口腔健康状况的影响因素(P0.05,P0.01)。结论社区老年留置胃管患者口腔健康状况不容乐观,主要照护者应重视老年患者留置胃管的口腔清洁,家属和社区工作者应提供正确的指引并关爱照护者,培养其正确的刷牙习惯。     

Diabetes empowerment scores among type 2 diabetes mellitus patients and its correlated factors: A cross-sectional study in a primary care setting in Malaysia

BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients, particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type2 diabetes patients in a primary care clinic in Malaysia.METHODS This is a cross sectional study involving 322 patients with type 2 diabetes mellitus(DM) followed up in a primary care clinic. Systematic sampling method was used for patient recruitment. The Diabetes Empowerment Scale(DES) questionnaire was used to measure patient empowerment. It consists of three domains:(1)Managing the psychosocial aspect of diabetes(9 items);(2) Assessing dissatisfaction and readiness to change(9 items); and(3) Setting and achieving diabetes goal(10 items). A score was considered high if it ranged from 100 to 140.Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.RESULTS The median age of the study population was 55 years old. 56% were male and the mean duration of diabetes was 4 years. The total median score of the DES was 110 [interquartile range(IQR) = 10]. The median scores of the three subscales were 40 with(IQR = 4) for "Managing the psychosocial aspect of diabetes"; 36 with(IQR = 3) for "Assessing dissatisfaction and readiness to change"; and 34 with(IQR = 5) for "Setting and achieving diabetes goal". According to multiple linear regressions, factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level(P 0.001), diabetes education exposure(P = 0.003),lack of ischemic heart disease(P = 0.017), and lower glycated hemoglobin(HbA1 c) levels(P 0.001).CONCLUSION Diabetes empowerment scores were high among type 2 diabetes patients in this study population. Predictors for high empowerment scores included above secondary education level, diabetes education exposure, lack of ischemic heart disease status and lower HbA1 c.     

The impact of perceived lack of support provided by health and social care services to caregivers of people with motor neuron disease

Our objective was to investigate the relationship between support by health and social care services and caregiver well-being. A survey, including a generic health status measure (SF-12), a disease-specific measure for patients (ALSAQ-40), the Carer Strain Index (CSI) for caregivers and questions on experiences of health and social care services, was sent to patient members of the MND Association (UK) and their caregivers. A single 'problem score' was calculated from the experience questions and the relationship between the problem score with caregiver and patient well-being was analysed. Most caregivers reported at least one problem with support from services. The most common problems were services not valuing caregivers' experiences, and caregivers not feeling sufficiently involved in planning care. The problem score significantly increased with increasing caregiver strain and worsening mental health. The problem score was also increased as patient well-being decreased. The results suggest that caregiver strain was higher and mental health lower as the number of problems reported increased. A higher perceived lack of caregiver support was also related to a decrease in patient well-being, suggesting that caregivers' needs increase as the disease progresses. This emphasizes the importance of MND caregivers being appropriately supported by health and social care services in their caregiving role.     

Patient-perceived barriers to surgical treatment of cleft lip and palate in Brazil: A multi-region study

IntroductionMany patients worldwide are unable to access timely primary repair of cleft lip and palate. The aim of this study was to assess patient-perceived barriers to accessing timely cleft lip and palate repair across Brazil.MethodsA 29-item questionnaire was applied to patients undergoing surgery for cleft lip and/or palate across five contrasting sites in Brazil from February 2016 to November 2017. Differences in patient timelines, demographics, and patient-reported barriers were compared by region. A multivariate logistic regression was used to determine predictors of delayed care.ResultsOf 181 patients, 42% of patients received timely primary surgical repair. The age of the patient at the interview was 82 months (standard deviation [SD] 107) and 52% were male. The majority of delays occurred between diagnosis and primary surgical repair. The mean number of barriers to accessing timely surgical care cited by each patient was 3.77. The most common barrier was perceived “lack of hospitals that provided the surgery in my area” (48% (n = 86)). Univariate logistic regression showed increased odds of receiving late care in the state of Amazonas (odds ratio [OR] 2.91; 95% confidence interval [CI] 1.07–7.96; P = 0.037) or Para (OR 4.46; 95% CI 1.09–19.70; P = 0.037). Multivariate logistic regression determined predictors of delayed care to be female sex (OR = 2.05; 95% CI 1.05–3.99; P = 0.035) and perceived poor availability of care (OR = 0.045; 95% CI 1.02–4.37; P = 0.045).ConclusionThe majority of patients in Brazil are not receiving timely primary repair of their clefts. Improvements in the coordination of care, patient education and patient empowerment are required.     

维持性血液透析患者社会疏离感的调查研究

目的 了解维持性血液透析患者的社会疏离感水平现状,探讨其影响因素,为医护人员制定护理对策提供参考。方法 采用一般资料调查表、一般疏离感量表对310例维持性血液透析患者进行调查。结果 维持性血液透析患者社会疏离感得分为(44.75±5.62)分。多元线性回归分析显示,年龄、文化程度、婚姻状况、在职情况、家庭居住地、病程、疾病复发次数、血液透析时长、血液透析频次、合并慢性病、是否清楚了解血液透析知识为社会疏离感的影响因素(均P<0.05)。结论 维持性血液透析患者社会疏离感程度较严重,医护人员可根据影响因素制定针对性干预策略,以降低患者的社会疏离感程度,促进其回归社会。     

非医疗因素对长期腹膜透析患者生存质量的影响

目的研究可能影响长期腹膜透析患者生存质量的非医疗因素,旨在为临床工作中如何提高患者的生存质量提供依据。方法采用横断面研究方法调查79例慢性肾衰竭进行持续非卧床腹膜透析（CAPD）患者。记录患者的年龄、性别、工作状况、文化程度、医疗负担及家庭支持等情况。采用国际通用的KDQOL-SFTM1．2中的短表SF-36评估患者的生存质量。采用汉密尔顿焦虑抑郁量表评估患者的焦虑、抑郁指数。结果SF-36评估患者的生存质量提示：CAPD患者生存质量的8个方面得分均显著低于中国一般人群（P〈0．05或〈0．01）;在职患者和有医疗保障患者sF-36得分分别为（45．78±16．93）分和（49．62±13．20）分,明显高于非在职患者的（32．65±12．26）分和无医疗保障患者的（33．85±6．24）分（P〈0．05）;人均年收入越高的家庭,患者生存质量就越高;有子女和老伴共同照顾的患者生存质量最高,而由保姆或个人照顾的患者生存质量最低;79例患者中焦虑的发生率为54．4％（43/79）,抑郁的发生率为15．2％（12/79）,二者均与生存质量呈显著负相关。结论家庭支持、工作状况、医疗保障和心理障碍均对CAPD患者的生存质量产生重要影响。